Older age key factor in suicide risk in Asian patients with early psychosis

Posted on November 16, 2013

Suicide risk among patients with first-episode psychosis appears to be greatest for older individuals with severe symptoms that have gone untreated for a long time, Asian study findings indicate.

High levels of functioning were also associated with an increased risk for suicide. Improvements in functioning may mask persisting core symptoms such as thought disorders and delusions and the underlying desire to commit suicide, the researchers explain.

The findings highlight “the need for a particularly thorough suicide risk assessment on the part of primary mental healthcare professionals for patients with [first-episode psychosis].”

Lead researcher Natasha Mitter (Institute of Mental Health, Singapore) and colleagues collected sociodemographic and clinical data on 1397 patients aged from 15 to 41 years (average of 27.7 years) living in Singapore. Over 2 years of follow-up, 26 (1.9%) patients committed suicide.

Most of the patients who committed suicide had a schizophrenia spectrum disorder and were single, and their median duration of untreated psychosis (DUP) was 6.5 months. The mean Positive and Negative Syndrome Scale (PANSS) total score and Global Assessment of Functioning Scale (GAF) total and disability scores among those completing suicide were 62.0, 43.0, and 45.6 respectively.

There were no significant differences between those who did and did not commit suicide at baseline. But Cox proportional regression models showed that older age (hazard ratio [HR]=1.42), longer DUP (HR=1.10), higher GAF disability scores (HR=1.11), and higher PANSS positive and negative scores (HR=1.05) were significantly associated with time to suicide.